tv Key Capitol Hill Hearings CSPAN June 18, 2014 2:00am-4:01am EDT
changing the competitive trade with the low price brokerage service the prevailing price has fallen from $30 down at 15 downing eight and that report was written in the year 2000. now is 2014 but the historic price of the gigabyte toward the storage lives at $10 but today it is $0.10 so with lower fees or commissions commissions, yes. they have come down but they have stopped and i could probably come down further the notion of the paving goes the way the price would go up is hard to justify but competitive forces will force that out of the market. . . and american history tv.
you know, when we first started planning this conference months and months ago our hope was to bring together enrollment leaders from across the country to reflect back on the historic first open enrollment time and share best practices for the future. we thought maybe a few couple hundred of our friends would come to d.c. for this, but we never expected that more than 900 attendees would join as from communities in 48 states -- [applause] yes, and credible. not just that, including the district of columbia and as far away as qualm. pretty amazing. so thank you all for being here and a thank-you for our generous sponsors, many of whom are in the room today. especially those that help make this conference possible. the robert wood johnson foundation, go health for
helping us all gather here today the fact that there are so many here in this room shows just how strong and passionate this coalition is. you represent a cross-section of the many industries to work together to make the first enrollment a success. government officials cannot help with trustee educators, insurance industry leaders, out of reach specialists and organizers. everyone here understands the importance of our work to engage consumers and spread the word about how they can benefit from coverage under the affordable care act. for those of us who have been working on expanding health care access and awareness we know that we have reached an incredibly important milestone. saying to the exceptional work of the people in this room more than 14 million americans and
counting have received health coverage the marketplace medicaid. give yourselves a round of applause. pretty amazing. [applause] and despite an unexpectedly rocky start you all made history by pouring through a few negative news cycles and keeping your eye on the ball. he stayed focused on educating consumers because they were hungry for the facts about how the law was presented to them and their families. you connected consumers with free in-person help. he made sure that they knew about the opportunities for financial assistance. finally making health insurance a reality for millions to could not afford it. and you stood ready to handle a third sign up as the deadline approached. here at in rural america we reach to more than 5 billion
consumers across the country with information about enrolling in coverage. they did not do that alone. over 230 employees worked hand-in-hand with over 200 partner organizations and tens of thousands of volunteers who share our commitment to connect consumers with the information and resources they need to get covered. through in powering public officials and local leaders to be messengers on health care in that community we reached thousands more and encourage them to live out the options available. we met consumers were they were on line and social media and shared coordinated enrollment messages with our partners to increase our reach. we worked with community colleges, health care advocates, providers, groups, government officials, and keep local organizations, just like all of you, to reach as many consumers as we could.
one of my favorites was when i had the chance to travel through texas and ohio. i saw the true scope of this work and how unique id is from community to community. in dallas i stood with 17 pastors on stage to placed to educate their congregations about their new options. in mcallen on the border in texas i stop by local library where enrollment assistance set up shop every day to serve their community. in cleveland i saw an overflowing in rome that event hosted by kaj of a community college, and in cincinnati i stopped by a health center with deep roots in the latino community. each city was different, and the effort in each city was different, but in every city there were local organizations and leaders with the vision to see the need and a willingness to philip. in every city that local
knowledge and personalized average was crucial to success, and that is why a is so exciting to be here with all of you today so that i can think you in person for the work they you have done and we can celebrate together. there is also someone else who wanted to thank all of you as well. a very busy man who could not be here today. someone who needs very little interaction and has played a big role in expanding coverage to millions of americans. without further ado alec like to play in message recorder frothy. >> thank you for being a part of our effort to enroll america. we have always said that change does not come from washington back to washington. ordinary americans stand up and make it happen. that is what in rural america has been doing from the
beginning. 8 million americans have signed at. some being covered for the first time. what does that mean? peace of mind for working families, freedom for young people who want to change jobs are entrepreneurs who want to change ideas, and justice for every woman who can no longer be charged more. that is why many of you joined this fight in the first place from community organizers and hospital leaders to navigators and officials. i could not be more grateful to you for all of your doing to help americans get covers. we need you to keep telling your stories.
and strengthen our partnerships with that we can continue to build on this important work for years to come. to kick off that process, we wanted to bring together experts from across the different industries who played a critical role in the historic development of the last year and take a look back on what we all experienced. we are very excited and thrilled by the lineup of the prominent healthcare leaders from the experience industry and policy world into state and federal government who have all agreed to join us today and i am particularly honored that kathleen sebelius, who as the secretary of health and human services shepherded the affordable care act from an idea into the law of the land and then to the reality for millions of american families has chosen to be here with all of us at her first public appearance since leaving hhs. we will hear first from the
panelists about their different perspectives on the first enrollment period and then we will have some time for the panel discussion stoop reflect on what worked well in on the obstacles we faced. so to start off i would like to welcome to the stage when of america's leading health policy experts president and ceo of the kaiser family foundation, doctor drew altman. [applause] the >> good morning and thank you very much. you know, when i was in the state government i was described in a major newspaper as a nice guy trapped in space. [laughter] so, i am really very happy to be here. there is just no way in the world that you would ever know that. i wanted very much to be here today because millions of uninsured people got coverage in this first open enrollment
season and no one did more to make that happen then the people in this room and while scheuer the partisan debate about the aca continues and we all know that we have a lot of work to do with another open enrollment season coming in our surveys show that still more than half of the uninsured are trying to figure out what the aca means for them on behalf of any of us in this room who come into the country who spent our entire livespend our entirelives workif the uninsured and the millions of americans who got coverage because of you, thank you for what you did this year. the enrollment success is also the result of leadership and i think that when you ask who are the leaders that you think of and it comes to expanding coverage number one, two, three, four, five, six for secretary sebelius and i would and to that
list even if she likes to stay in the background she can't hide any longer. she's no longer in the background as it is a pleasure for me personally to be here with everyone who will be on the stage and just a minute. now as the ceo of the family foundation i'm sure that you are expecting a lot of data from me here this morning because that is kind of the organization that you know that i have established. but i'm actually throwing out my own script. i want to tell you three quick stories and just make a few very basic point. the first is a story from my time in the state government as the new jersey human services commissioner under the great governor named tom came to you y just remember was a while ago as the chair of the 9/11 commission. i made my name in the state government doing welfare reform, but one thing i put a great effort into is developing a school-based program for the youth all across the state of new jersey. we actually did a lot of good
things in new jersey we even kept the bridges to new york over. [laughter] drove them in case we had to escape from new jersey. anyway, i was in cumberland county, which is in south jersey and at the time it was the poorest state that had worse statistics than new art and if you don't know it's actually below the mason dixon line and i was meeting with young people and i was asking them which services are most important, what about behavioral health, do you want clinics in the schools were here in the schools, you know, they were a technocratic commissioners program designed question and there was this one younger guy that was very small environment version was sitting in the back of the room and he just looked up at me and he said you know, commissioner, you're just an idiot. it's not this or that service. what we really need is somebody that we can talk to who we trust. from that day on, whether it was organizing services for at-risk
youth or hiv prevention programs in a squatter communities in big cities across south africa were programs for the usa and outreach for the uninsured, here in the states to community-based outreach has been a cornerstone of really every successful program that i've been involved in. our surveys show that about half of the uninsured have been insured -- okay, half of the uninsured have been insured for two years or more or have never had insurance. about 20 percent do not have access to the internet. the national debate that we have this year focused on the website problems and focus on what i call the aca's actuarial mission making sure that there are enough people in the risk pool that is a healthy risk pool coming it if it is a very, very -- you know, we have to have that. it's a very, very important thing.
what is the point of all of this if it isn't also to reach the long-term uninsured, the folks who made the coverage the most and that will not happen without the community-based outreach and enrollment services and that isn't just in the survey data for me, it is a lifelong lesson that i first learned when the young gentleman in new jersey called me an idiot. idiot. i'd be oidiot. either they all be unfortunately politicized question of whether any of the folks who helped get coverage were previously uninsured while i can't release the numbers get we have a very important study of the nongroup market coming out on thursday of this week which would show a large percentage that got coverage in the exchanges that were previously uninsured so so much for that may 2 story is about a guy named duffey that
clears the timber in the mountains not far from where kaiser is based. he works like a dog when he gets work which is in fact -- he has all kind of health problems i won't go into but when you ask him why he doesn't have coverage committees is of course that he can't afford it. so i show him the tax credits and i also showed him the deductibles. duffey had no idea what a premium was or what a deductible was. you were all dealt with a lot of duffy's because he didn't have any computers or how to use one and he had absolutely no idea where to go for health. he said that he had heard about obamacare and that he had read that obamacare was broken so she didn't pursue it. that was during the website problems. ultimately he went to the local counties and services agency where they walked him through the process and it turned out that he qualified for medicare but she was absolutely thrilled about. health coverage had always been
on affordable for duffy comes to knowing about this independent medicare coverage, that made all of the difference in the world for duffy. this should be no surprise to anybody in this room because since the beginning i think of the recorded time any study that we have done of the uninsured have shown that the main reason for ththat the uninsured don't e coverage of the can't afford it. it also mattered that duffy was required to buy insurance as a penalty at the grove. there was a deadline. duffy didn't know that. it didn't matter to him. so for duffy and millions more, according to research, financial assistance into the afford ability really matters. it's a central message. it may be the central message and demand these matters, too. there are a lot of other stories in the duffy story about families and friends helping the sisters of the national media association, but let me just close with my last story.
this is a story that i'd have occasionally that is one of my favorite stories of my first day on the job of the human services commissioner of new jersey. the problem i have is i couldn't find the job. to go to trenton new jersey if you don't have to go to trenton new jersey. jersey. and so, i went and i wandered around i and i couldn't find the building. there was a big building. i thought that it was a place but it didn't have a sign in front of it and it was a guard and i was very young at the time and he said just go in there. so i went in there and i had my big idea. this is how i was going to take control of this very large agency. i went to the ninth floor and said hello to everybody and then i said my big idea. what is wrong with all of us? we are the largest organization. we were then in new jersey bigger than the drug companies in new jersey. we should be proud of what we do and we will be a sign in front of this building. welcome to ninwell, nine monthsr the job because of the
procurement rules were used and then stopped again because the team worked on the job had been stopped a third time in the wonderful -- and i love this letter from the state department of treasury that said that this job shouldn't go forward because it is too small to do. [laughter] they called me out to the front of the building. the press was there, about a thousand people were there. it was my birthday. there were stories. will commissioner altman at his sign back there was a giant sheet in front of the building and they pulled the sheet back and there it was, the new jersey state department of "hunan services." [laughter] i wanted to keep the sign in to change the services. [laughter] it took me nine months to get a sign. big changes like the aca take time -- [laughter] and that is especially true for
the law like the aca which is going to play out differently in different states and people depending on their income and employment circumstances and where they live. in a national debate about aca, it's either good or bad. that's the debate we are having come a binary debate depending on your partisan politics. but, if you somehow force people to take off the partisan glasses, i think the defining characteristic of the aca is its variability. i wish we had a congress which could learn from that very issue from this great national experiment. we don't. but states do watch other states and they can learn. as we look ahead may be the politics of the aca will change after 2016. maybe it will no longer even be called obamacare -- maybe, right. but one thing i do know is that more than any other factor, it will be your efforts, the
efforts of the people in this room that determine the success reaching people who need coverage the most. so, on behalf of the kid of new jersey that called me an idiot and a duffy and the new jersey department of hunan services, whoever it is, thank you very much. [applause] >> thank you so much, drew. next up, we have one of the most experienced and insightful leaders in the health insurance industry today. the president and ceo of independent blue cross dan hilferty. [applause] >> good morning. well done and thank you so much to enroll america for including me in this very important discussion.
one of the heroes in getting well over 8 million people enrolled across the country is the work that she has done so she deserves a round of applause. [applause] >> is an honor for me to be here with the governor beshear, the great commonwealth of kentucky. although i'm from pennsylvania i have a fondness for kentucky, and even in the dark days of the rollout, the governor beshear is one of the folks that stood up in front of the national media and talked about how things were working in kentucky. and although many of us were not so sure at the time, he was steadfast in his belief that this was the right way to go. also, secretary said elliott, whether she was the insurance commissioner of the governor of kansas were her latest role as the secretary of health and human services, regardless of one's politics, it is amazing that an implementation of this
magnitude of this complicated nature could be done in such a short period of time so i'm thrilled to be here with them and of course with drew, who you heard from. i would like to acknowledge another group of people in this room. if you think about the grassroots effort, if you think about educating people on the need for enrolling in some plan to cover themselves in to cover their families, you are there day in and day out so congratulations to you as well. i know you're from all over the country as ann mentioned, so i would like to give a brief independence of who blue cross is. we are headquartered in philadelphia if we are to plan for five philadelphia counties, but through our health company affiliate, we are in 24 states and the district of columbia and we touch the lives of about 9 million people in all of those two restrictions --
jurisdictions. as the leader of a major health insurer, people say to me you must have really been busy over the past year with reform, and it's true. and i would like to give you a quick thought on how things change. i can remember with the rollout and the problems in the website i couldn't walk around the neighborhood. i couldn't walk my kids to a school or an events without somebody stopping me and asking me about it. just this past weekend to -- inc. you may be able to tell from my voice -- my oldest daughter was married and there were a couple hundred of their friends in their mid to late 20s who really is one of the key targets of this incredible reform initiative. and there was a lot of dancing and a lot of fun. i tried to be one of the younger people. [laughter] not successfully. but not one question about
reform. and that's not because they are disinterested, and that's not because they don't worry about it. it's because they are finally getting it. they are finally being educated. they are finally understanding the importance of taking their own and being accountable for their own care and their own coverage. that is a positive thing so i just wanted to give you that piece. but it is true. the fact of the matter at independence blue cross, we have been preparing for the reform for years. i know i speak for all of the blues across the country. we belief that reform was needed assistance the law was enacted in march of 2010, we've been an active participant. had we voiced our concerns about several areas? yes. secretary sebelius and her team were always there to listen. they didn't always agree or support our position, but they were there to listen. and in the insurance industry, there was a lot of concern about
reform. some insurance companies decided well, we are going to wait it out. we are good to see how this plays out. but the blues understood and i'm happy to see that we lead the charge. here's why. regardless of one's politics, regardless of where you stand on the affordable care act, regardless of who you support in your local elections and state elections and federal elections, the health care system was and in some ways continues to be broken and we needed to change it. when health care spending accounts for nearly one fifth of america's gross domestic product and when half of american adults go without recommended health care, when we spend more on healthcare than any other nation in the world, and yet americans are no healthier, when 50 to 60 million americans have no coverage, something is wrong. something is broken.
the affordable care act is not going to solve all of the challenges facing america's health care system. but it's a start. and through your efforts it is for the big shift of the health insurance business into traditionally the independents paying customers or the main business is. there are large employers to provide health care for their employees. we have a small customer based on the individual consumer market. we know that all of this was about to change in has changed. as we move forward the individuals become the key part of our efforts. it's now not only a consumer of a business to business, but it is a business to consumer business. the affordable care act has led to what some have called the
amazonification. they can now go online to the public exchange and in a few clicks see the range of coverage options and sorts them by price. in our markets, we had 13 different products, 30 variations i'm happy to see the lowest price people could shop and find what they needed. this is as great an opportunity for an individual to get coverage in our nations history. we found that consumers were joined to the competitive pricing and develop physicians, hospitals and other healthcare professionals in our market. i am very proud to tell you that in the first open enrollment-we gained more than 285,000 285,000 enrollees. that is well over 8 million. that does not include in the various states where we do medicaid managed care, where we
picked up several hundred thousand because folks now have access to coverage. but we budgeted 285,000 we budgeted well over 100,000. so that should speak to the success that you have fostered during this enrollment period. this exceeded our expectations. iab leave that there are a number of reasons we were successful in signing up so many individual consumers. for starters, we have gone the extra mile to make it simple and easy for consumers to sign up for coverage and get the care they need. also, we particularly want young people to enroll with us as i said earlier so we use digital media to reach out to them where and how they want to be reached. we were pretty successful and although we didn't expect it, 30% of the sign-ups in